Approach to Diagnosis of Anemia in Patient with Chronic Kidney Disease

Authors

  • Alif Fernanda Putra Medical Faculty, Lampung University
  • Yusuf Aulia Rahman Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Lampung

Keywords:

anemia, chronic kidney disease, diagnostic

Abstract

Globally, anemia occurs in 1.62 billion individuals or around 24.8% of the population. In Indonesia, anemia occurs in about 15.4% of the population. Anemia is often a problem with misdiagnosis and inaccurate management. The male patient presents with weakness since the last month. The patient began to feel symptoms of hypertension (220/110 mmHg) at 3 months ago accompanied by tightness, itching in the body, weakness and pale days, swelling almost all over the body, and decreased urine. On physical examination, there was hypertension (160/90 mmHg), the conjunctival was anemic and on the palpebrae, superior and inferior limbs there was pitting edema. On supporting examination, it was obtained patient with normocytic and normochromic anemia Hb 5 g/dL, erythrocyte 1.8 million/μL, hematocrit 15%, LED 90 mm/hour, ureum 486 mg/dL, creatinine 39.28 mg/dL, calcium 4.7 mg/dL, chloride 92 U/L, sodium 124 mmol/L, and potassium 6.6 mmol/L. USG of the abdomen shows the results of bilateral chronic kidney disease. Management of anemia in patients needs to be holistic considered starting from the causes and the choice of therapy used in order to reduce morbidity and mortality and improve the patient's quality of life. This journal will explain the approach to anemia through illustrations on case of patient with anemia in chronic kidney disease.

References

Chapparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low and middle-income countries. Ann N Y Acad Sci. 2019;(1):15-31.

Barkley JS, Kendrick KL, Codling K, Muslimatun S, Pachon H. Anaemia prevalence over time in Indonesia: estimates from the 1997, 2000, and 2008 Indonesia Family Life Surveys. Asia Pacific Journal Clinical Nutrition. 2015;24(3):452-55.

Kimura T, Snijder R, Nozaki K. Diagnosis Patterns of CKD and Anemia in the Japanese Population. Kidney Rep. 2020;5(5):694-05

Akin S, Ergin E, Kazan S, Tukel NK, Aydin DK, Tekce M, et al. Assesment of the patients presenting with severe anemia to the emergency internal medicine clinic. Journal North Clin Istanbul. 2014;1(2):84-88.

WHO. Haemoglobin concentration for the diagnosis of anaemia and assessment of severity. Micronutient indicator. 2011

Fauci AS, Kasper DL, et al. Harrison’s Principles of Internal Medicine. Edisi ke-19. New York: McGrawHill; 2015

Perhimpunan Dokter Spesialis Penyakit Dalam. Buku Ajar Ilmu Penyakit Dalam Edisi ke-6. Jakarta: InternaPublishing; 2014

Yenilmez ED, Tuli A. Laboratory Approach to Anemia. Current topics in anemia. Intech; 2018.

Buttarello M. Laboratory diagnosis of anemia: are the old and new red cell parameters useful in classification and treatment, how?. International journal of laboratory hematology. 2016. 38(1);123-32.

Alli N, Vaughan J, Patel M. Anemia: Approach to diagnosis. South African medical journal. 2017; 107(1);23-7.

KDIGO. Diagnosis and evaluation of anemia in CKD. Kidney International Supplements. 2012. 288-91

Ashraf M, Christopher B, Jennifer W, Vinod M, Rajesh S, Jonathan E, et al. Clinical Practice Guideline: Anaemia of Chronic Kidney Disease. The renal association. 2017.

Banzi R, Gerardi C, Bartele V, Garattini S, Schieppati A. Application for erythropoietin-stimulating agents (erythropoietin type blood factors). WHO EML 2016-2017. 3:1-46.

Additional Files

Published

2022-08-10

Issue

Section

Articles